The prostate requires androgens for development and glandular maintenance, dying by the process of apoptosis following their removal. Anti-androgen therapy is targeted to induce this process but eventually fails with the emergence of an androgen independent cancer. These cells have development mechanisms to survive with out androgen impart due to the expression of anti-apoptotic factors.

Androgens↗

PubMed2002

A shared care approach to the management of erectile dysfunction in the community.

Erectile dysfunction (ED) affects men of all ages and results in considerable distress and impact on quality of life for those who suffer from it. As ED is associated with a wide variety of under-lying conditions and cardiovascular co-morbidities, there is a requirement for diversity of treatment options and several factors must be considered to customise and optimise therapy. In the ideal holistic approach to management of the ED patient, both primary care and specialist physicians have an important role to play. This article reports on a sequential approach for the diagnosis and treatment of ED, with an emphasis on 'shared care'. The deliberations are based on a pan-European inter-disciplinary group that met at the Lygon Arms, UK on 22 February 2002.

Erectile Dysfunction↗

PubMed2002

Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators.

Herniated intervertebral disc tissue has been shown to produce a number of proinflammatory mediators and cytokines, but there have been no similar studies using discs from patients with discogenic low back pain. We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay. There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively). The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.

Adult↗

PubMed2002

The loss of IAP expression during HL-60 cell differentiation is caspase-independent.

Human promyelocytic leukaemia cells (HL-60) differentiate into neutrophil-like cells that die spontaneously by apoptosis when treated with retinoic acid (RA). Inhibitors of apoptosis proteins (IAP) bind to and inhibit caspases 3, 7, and 9 activity and the induction of apoptosis. In this study, we demonstrate that undifferentiated HL-60 cells express IAP. During their differentiation, IAP expression is decreased at the mRNA and protein levels. In addition, we show that there is a corresponding increase in the expression and functional activity of active caspases 3 and 9. This activity was associated with the cleavage of XIAP, NAIP, and cIAP-2. Most importantly, we demonstrate that blocking caspase activity does not alter the decrease in IAP protein expression during differentiation but prevents caspase activation, IAP cleavage, and the induction of apoptosis. This result shows that the loss of IAP expression is independent of the induction of apoptosis and is solely related to the differentiation process. However, IAP cleavage is caspase-dependent. Terminal differentiation results in an altered apoptotic phenotype that is associated with the induction of HL-60 cell apoptosis.

Apoptosis↗

PubMed2001

Priming prostate carcinoma cells for increased apoptosis is associated with up-regulation of the caspases.

BACKGROUND: The potential to prime prostatic carcinoma cell lines for apoptosis represents an exciting strategy for the treatment of patients with this disease. The ability and the underlying molecular mechanisms involved in sensitizing both androgen-sensitive and androgen-insensitive cell types to a range of apoptotic-inducing agents are investigated by the authors. METHODS: Primary and secondary cell lines were pretreated with diethyl-maleate (DEM) prior to the induction of apoptosis by Fas antibody (1 microg/mL), cycloheximide (1 microg/mL), etoposide (62.5 microM), and radiation (5 grays). It was demonstrated previously that DEM (50 microM) increases the sensitivity to apoptosis induced by these agents. The effects of DEM on both protein and RNA expression was determined by Western blot analysis and a ribonuclease protection assay, respectively. The effects of DEM on intracellular glutathione (GSH) levels and its intracellular distribution also were assessed. RESULTS: DEM did not affect the expression of the caspases at the transcriptional level but was associated with increased procaspase-3 and caspase-8 protein levels. DEM preincubation restored sensitivity to Fas antibody and radiation-induced apoptosis in cells from the LNCaP-bcl-2 transfectant cell line that, normally, are resistant to these apoptotic stimuli. It is that DEM chemically depletes intracellular thiol levels. Although no depletion in total intracellular thiol GSH was observed at these concentrations of DEM, trafficking of GSH from the nucleus to the cytosol was demonstrated. CONCLUSIONS: Identification of the caspases as a potential target for chemical manipulation may serve as an effective, adjuvant-based approach in the treatment of patients with prostate carcinoma and, in particular, for immunotherapy and radiation-based strategies that rely on the activation of these death-effector proteases.

Antineoplastic Agents, Phytogenic↗

PubMed2001

Caspase 3 expression in benign prostatic hyperplasia and prostate carcinoma.

BACKGROUND: Apoptotic resistance to androgen ablation represents a significant problem in the treatment of prostate cancer. Over expression of antiapoptotic proteins such as Bcl-2 and mutations in p53 contribute to this resistance. The caspase family of proteases are central executioners of the cell death pathway. They are expressed in normal prostate secretory epithelial cells. Altered expression may represent an additional component leading to cell resistance. The aim of this study was to determine by immunohistochemistry caspase 3 expression in benign prostatic hyperplasia and prostate cancers. METHODS: Twenty-two patients with histologically determined prostate cancer and benign prostatic hyperplasia (BPH) were investigated. All specimens were obtained from patients undergoing surgical resection of the prostate. Immunohistochemical analysis was performed on formalin fixed paraffin embedded sections to assess caspase 3 expression. RESULTS: Caspase 3 was expressed in 18/22 (81.1%) samples, with high expression in BPH which demonstrated staining in both basal and secretory epithelial cells. Increasing grades of prostatic cancer showed a significant loss of expression in secretory epithelial layers and little staining in epithelial cells in high-grade prostatic carcinoma. CONCLUSIONS: Altered caspase 3 expression may represent an additional mechanism of apoptotic resistance to androgen ablation. Prostate 47:183-188, 2001.

Apoptosis↗

PubMed2001

Sexual function in patients with benign prostatic hyperplasia.

Sexual health has significant impact on quality of life among men with benign prostatic hyperplasia (BPH). The degree of sexual dysfunction matches the severity of lower urinary tract symptoms (LUTS). Treatment of BPH affects not only LUTS, but sexual function as well. Medical, surgical, and minimally invasive therapies differ in their effect on erectile function, ejaculation, and sexual satisfaction. Choice of treatment modality takes into account baseline sexual function and patient expectations. This review outlines the relationship between LUTS and sexual function and how they change with the currently available treatments.

Humans↗

PubMed2001

Insulin-like growth factor I and prostate cancer.

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Animals↗

PubMed2001

Annexin-V imaging for noninvasive detection of cardiac allograft rejection.

Heart transplant rejection is characterized pathologically by myocyte necrosis and apoptosis associated with interstitial mononuclear cell infiltration. Any one of these components can be targeted for noninvasive detection of transplant rejection. During apoptotic cell death, phosphatidylserine, a phospholipid that is normally confined to the inner leaflet of cell membrane bilayer, gets exteriorized. Technetium-99m-labeled annexin-V, an endogenous protein that has high affinity for binding to phosphatidylserine, has been administered intravenously for noninvasive identification of apoptotic cell death. In the present study of 18 cardiac allograft recipients, 13 patients had negative and five had positive myocardial uptake of annexin. These latter five demonstrated at least moderate transplant rejection and caspase-3 staining, suggesting apoptosis in their biopsy specimens. This study reveals the clinical feasibility and safety of annexin-V imaging for noninvasive detection of transplant rejection by targeting cell membrane phospholipid alterations that are commonly associated with the process of apoptosis.

Adult↗

PubMed2001

Defining a role for the inhibitors of apoptosis proteins in prostate cancer.

The aim of this paper is to review the inhibitors of apoptosis proteins, a recently discovered group of caspase inhibitors. We will briefly review the relevance of apoptosis in prostate cancer and some of the control mechanisms, before describing the structure, function and regulation of these molecules. Lastly, we will consider the evidence for the role that IAPs may have in cancer and the implications for prostate cancer in particular. Prostate Cancer and Prostatic Diseases (2001) 4, 28-32

Journal Article↗

PubMed2001

Introduction.

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Journal Article↗

PubMed2001

An autoradiographic study of regional blood flow distribution in the rat kidney during ureteric obstruction--the role of vasoactive compounds.

OBJECTIVE: To determine the changes in regional renal blood flow during ureteric obstruction and to examine the role of vasoactive mediators in effecting these changes. MATERIALS AND METHODS: Renal blood flow in Sprague-Dawley rats was assessed after periods of ureteric obstruction using a quantitative autoradiographic technique based on Kety's theory of diffusion of an inert tracer (14C-iodoantipyrine). Prostaglandins, thromboxanes and renin-angiotensin were inhibited pharmacologically using diclofenac sodium and enalapril. RESULTS: Baseline blood flow to the outer cortex, inner cortex and medulla was 807, 258 and 105 mL/100 g/min, respectively. There was an increase in outer cortical blood flow after 10 min of ureteric obstruction which became significant at 30 min (P < 0.05). There was a significant decrease in inner cortical and medullary blood flow at 30 min, to 210 and 68 mL/100 g/min, respectively (P < 0.05). Diclofenac sodium abolished the increase in outer cortical blood flow. After 24 h of unilateral ureteric obstruction, outer cortical blood flow decreased to 492 mL/100 g/min; inner cortical blood flow also decreased but to a lesser extent, to 190 mL/100 g/min. Inhibition of prostaglandins, thromboxanes and the renin-angiotensin system reduced the degree of renal vasoconstriction but there was still a significant decrease in outer cortical perfusion despite the presence of these blocking agents. CONCLUSIONS: The control of the renal vasculature involves a complex interplay between a variety of vasoactive mediators. Quantitative autoradiography offers the opportunity to evaluate changes in regional renal perfusion with high resolution and will allow a greater understanding of the pathophysiology of renal diseases.

Animals↗

PubMed2001

Nitric oxide in unilateral ureteral obstruction: effect on regional renal blood flow.

BACKGROUND: Ureteral obstruction (UO) is characterized by reduced blood flow and loss of tissue mass in the involved kidney(s). Vasoactive mediators interact to produce an initial hyperemia, followed by a sustained decrease in renal blood flow in the obstructed kidney. Nitric oxide (NO) has been shown to play a central role in the acute hyperemic response to UO. Its role in the reduced perfusion of prolonged UO is less studied. METHODS: Ureteral obstruction was achieved by ligation of the distal left ureter and maintained for 24 hours. Blood flow was studied in untreated animals and after the administration of the NO synthase (NOS) inhibitor N-mono-methyl L-arginine and the NO donor sodium nitroprusside. Tissue was collected for localization and quantitation of NOS. Serum and renal tissue L-arginine levels were measured in control and UO settings. RESULTS: Blood flow in the obstructed kidney diminished to approximately 50% of control values after 24 hours of UO. NOS blockade led to a further decrease in blood flow. Supplementation with exogenous nitrates restored renal blood flow to levels approaching control values. Serum and tissue L-arginine levels did not change with UO. NOS expression was seen to increase with increasing duration of obstruction, with staining most pronounced in the renal tubules. CONCLUSIONS: NO plays a vasodilatory role even in the hypoperfusion of prolonged UO. The administration of exogenous nitrates has a restorative effect on blood flow, suggesting therapeutic potential in UO.

Animals↗

PubMed2001

Signaling for the caspases: their role in prostate cell apoptosis.

PURPOSE: The caspases are an evolutionary conserved family of cell death proteases. Their activation during apoptosis is an important underlying theme in prostate cancer therapy. We summarize the signaling pathways leading to the recruitment of the caspases and address the importance of recent therapeutic strategies aimed at specifically targeting these proteases in relation to prostate cancer. MATERIALS AND METHODS: We present a background introduction into the role of the caspases in apoptosis and how failure to signal effectively their activation may contribute to prostate cancer progression. Key studies aimed at specifically targeting the caspases as cancer therapy are discussed. RESULTS: Prostate carcinogenesis and apoptosis are related. The deregulation of apoptosis contributes to tumor initiation, metastasis and progression to the androgen insensitive state. Conversely the effectiveness of therapy often depends on its ability to induce apoptosis in prostate cancer cells. Identifying abnormalities in the apoptotic signaling pathway has greatly contributed to understanding the biology of prostate cancer. Elucidating caspase regulation has contributed to the design of novel therapies for prostate cancer. CONCLUSIONS: We summarize the physiological and pathological pathways leading to caspase activation in the prostate and describe novel approaches that target these proteases.

Apoptosis↗